Larsen Peter D, De Silva Praveen, Harding Scott A, Woodcock Ellen, Lever Nigel A
Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand.
N Z Med J. 2010 Feb 19;123(1309):76-85.
Implantable Cardioverter Defibrillator (ICD) therapy is now standard of care for prevention of sudden cardiac death in high-risk patient groups. In order to determine if the potential benefit of ICD therapy is being realised, ongoing monitoring of ICD therapy is required. This study was conducted to examine ICD therapy in two New Zealand tertiary hospitals.
We retrospectively audited patient notes for all patients receiving a first ICD between 2000 and 2007 at two tertiary referral hospitals in New Zealand.
702 patients received their first ICD within the study period, 73% male, mean age 53 years (range 1 to 83), with 73% of devices for secondary prevention. The implant rate increased from 15/million in 2000 to a peak of 44/million in 2004. Antitachycardia pacing was delivered to 21% of patients, appropriate defibrillation to 26% and inappropriate defibrillation to 16% of patients, with frequency of all types of therapy increasing with time since implantation. All cause mortality was 8.6%, and only 7 (1%) died as a consequence of sudden cardiac arrest.
While increasing across the study period, the ICD implant rate remains low, with a high therapy rate and low mortality rate. This suggests that those receiving ICD therapy are benefiting, but may also imply that the group of patients receiving ICDs is too restricted.
植入式心脏复律除颤器（ICD）治疗现已成为高危患者群体预防心脏性猝死的标准治疗方法。为了确定ICD治疗的潜在益处是否得以实现，需要对ICD治疗进行持续监测。本研究旨在对新西兰两家三级医院的ICD治疗情况进行调查。
我们对2000年至2007年间在新西兰两家三级转诊医院接受首次ICD植入的所有患者的病历进行了回顾性审核。
在研究期间，702例患者接受了首次ICD植入，其中73%为男性，平均年龄53岁（范围1至83岁），73%的设备用于二级预防。植入率从2000年的15/百万增加到2004年的峰值44/百万。21%的患者接受了抗心动过速起搏治疗，26%的患者接受了适当的除颤治疗，16%的患者接受了不适当的除颤治疗，所有类型治疗的频率均随植入后的时间增加。全因死亡率为8.6%，仅有7例（1%）因心脏骤停死亡。
虽然在研究期间ICD植入率有所上升，但仍然较低，治疗率高而死亡率低。这表明接受ICD治疗的患者从中受益，但也可能意味着接受ICD治疗的患者群体过于局限。
